SAMUEL DOMINICO Perfusionist License verification

Business Entity

INACTIVE

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000091

License Status

INACTIVE

Business

First Name

SAMUEL

Last Name

DOMINICO

Business Name

SAMUEL DOMINICO

Original Issue Date

01/03/2003

Effective Date

03/16/2004

Expiration Date

04/30/2006

City

WINSTON SALEM

State

Zip

27106

Ever Disciplined

LastModifiedDate

06/05/2006